İlaç Politikaları Ne Zaman Uygulanmalı: Periyodik Bütünleşik Reçete Başına Ortalama Maliyet Verisinden Çıkarımlar
Abstract
Giriş: İlaçlar, sağlık hizmetlerinin ayrılmaz bir parçasıdır, bu nedenle fiyatlarının dinamikleri sadece firmaları değil, halkın refahını da etkiler. Bu çalışma, serinin periyodik yapısından yararlanarak, politika uygulaması amacıyla ilaç fiyatlarının dinamiklerini ve şokların seriler üzerindeki etkisini araştırmayı amaçlamaktadır.
Gereç ve Yöntem: Çalışma, son kullanıcı fiyatlarına odaklandığından, fiyat verileri ortalama reçete maliyeti olarak alınmıştır. Veriler, Sosyal Güvenlik Kurumu Aylık İstatistik Bültenlerinden alınan bir zaman serisi olup 2008m12 - 2020m02 dönemini içermektedir. Seri, periyodik modeller kullanılarak incelenmiştir.
Bulgular: Serinin güçlü bir periyodiklik gösterdiği, ayrıca periyodik entegre olduğu tespit edilmiştir. Sonuç olarak, reçetelerin aylık ortalama fiyatı, periyodik olarak entegre edilen otoregresif modeller kullanılarak modellenmiştir. Modellerin zamana göre değişen şok birikimleri, ilkbahar ve yaz aylarındaki şokların serinin stokastik eğilimini değiştirebilecek şekilde en şiddetli etkiye sahip olduğunu göstermektedir. Ek olarak, kış şoklarının uzun vadede büyük etkileri vardır.
Sonuç: Şoklar, devletin eczacılık politikalarına yönelik politikaları olarak kasıtlı veya pandemi, döviz kurlarında beklenmeyen dalgalanmalar gibi kasıtsız olarak ortaya çıkabilir. Bir yandan, kışın kasıtlı şokların daha uzun vadeli etkileri vardır, ancak bu tür şokların serinin dinamiklerini değiştirmesi daha az olasıdır. Öte yandan, kışın istenmeyen şoklar, etkileri uzun süreli olacağından dikkatli davranılmalıdır. Son olarak modeller, ilkbahar ve yaz mevsimlerindeki politika şoklarının başarılı olma olasılığının daha yüksek olduğu, ancak bu mevsimlerde kasıtsız bir şok meydana geldiğinde politika yapıcıların hızlı hareket etmesi gerektiği konusunda hemfikirdir.
References
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When to Implement Pharmaceutics Policies: Deductions from the Periodically Integrated Average Cost per Prescription Data
Abstract
Introduction: Pharmaceutics are integral to the healthcare; therefore dynamics of their prices affects not only firms but the wellbeing of the public as well. Consequently this study aims to investigate the dynamics of the pharmaceutical prices as well as the effect of shocks on the series for the purpose of policy implementation, exploiting the periodic structure of the series.
Materials and Methods: The study focuses on the end user prices hence the price data is taken as average price of prescriptions. The data is a time series obtained from Social Security Institution’s Monthly Statistical Bulletins and includes the period 2008m12 - 2020m02. The series is investigated using periodic models.
Results: The series depicts strong periodicity, moreover it is found out to be periodically integrated. Consequently the monthly average price of prescriptions is modeled using periodically integrated autoregressive models. The time varying accumulations of shocks of the models indicate the shocks on spring and summer months have the most severe effect such that it may change the stochastic trend of the series. Additionally shocks on winter have large long-run impacts.
Conclusion: The shocks can occur intentionally as government policies on pharmaceutics or unintentionally such as pandemics, unexpected fluctuations in exchange rates. On one hand intentional shocks in winter have larger long run effects, but such shocks are less likely to change the dynamics of the series. On the other hand unintentional shocks at winter should be dealt carefully since their effect is going to be long lasting. Finally the models agree that policy shocks in spring and summer seasons are more likely to be successful whereas policy makers must take swift action when an unintentional shock occurs in these seasons.
References
- 1. Oguz AB. Turkish Health Policies: Past, Present, and Future. Social Work in Public Health. 2020:35(6): 456-472.
- 2. Bostan S. What Has the Health Transformation Program in Turkey Changed for Patients? Hacettepe Sağlık İdaresi Dergisi. 2013:16(2):91-103.
- 3. Atun R, Aydın S, Chakraborty S, et al. Universal health coverage in Turkey: enhancement of equity. Lancet. 2013:382(9886):65–99.
- 4. Hone T, Gurol-Urganci I, Millett C, et al. Effect of primary health care reforms in Turkey on health service utilization and user satisfaction. Health Policy Plan. 2017:32(1):57– 67.
- 5. Çetin FG. Sağlıkta Dönüşüm Programı Ekseninde Sağlığın Ekonomi Politiği. Gazi Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2017:19(1):274-293.
- 6. Öztürk S, Başar D, Özen İC, et al. Socio-economic and behavioral determinants of prescription and non-prescription medicine use: the case of Turkey. Daru. 2019:27(2):735-742.
- 7. Yılmaz ES, Koçkaya G, Yenilmez FB, et al. Impact of health policy changes on trends in the pharmaceutical market in Turkey. Value Health Reg Issues. 2016:10:48-52.
- 8. Gürsoy K. An Overview of Turkish Healthcare System after Health Transformation Program: Main Successes, Performance Assessment, Further Challenges, and Policy Options, Sosyal Güvence Dergisi, 2015:7:83-112.
- 9. Gürsoy K, Köselerli R, Dogru ST et al. How is current Pharmaceuticals Pricing Policy on generics Performing in Turkey Regarding Price Erosion. Value Health. 2014:17(7):A407.
- 10. Gürsoy K. How is current Pharmaceuticals Pricing Policy on generics Performing in Turkey Regarding Price Erosion. Sosyal Güvence Dergisi. 2017:11:62-78.
- 11. Elseviers M, Andersen M, Benko R, et al. Drug utilization research: Methods and applications. New Jersey, Wiley-Blackwell, 2016.
- 12. Hyndman R. Cyclic and seasonal time series. Uploaded to Hyndsight blog at December 11th, 2011 http://robjhyndman.com/hyndsight/cyclicts/ (Access date 01.09.2014)
- 13. Franses, P. Periodicity and stochastic trends in economic time series. Advanced Texts in Econometrics. Oxford: Oxford University Press, 1996.
- 14. Lopez-de Lacalle, J. Periodic autoregressive time series models in R: The partsm package. BILCODEC 2005 working paper. http://econpapers.repec.org/software/ehubilcod/200501.htm, 2005.
- 15. Greene WH. Econometric Analysis,7th ed. Pearson, 2017.
- 16. Franses P, Paap, R. Periodic Time Series Models, Advanced Texts in Econometrics. Oxford: Oxford University Press. 2004.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Articles |
| Authors | |
| Publication Date | August 31, 2021 |
| Acceptance Date | July 23, 2021 |
| Published in Issue | Year 2021 Volume: 4 Issue: 2 |
